Abstract
BackgroundThe comorbidity of purging behaviours, such as vomiting, inappropriate use of laxatives, diuretics or slimming medications, has been examined in literature. However, most studies do not include adolescents, individuals who purge in the absence of binge eating, or those purging at subclinical frequency. This study examines the prevalence of purging among 16-year-old girls across three countries and their association with substance use and psychological comorbidity.MethodsData were obtained by questionnaire in 3 population-based cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), United Kingdom, n = 1,608; Growing Up Today Study (GUTS), USA, n = 3,504; North Finland Birth Cohort (NFBC85/86), Finland, n = 2,306). Multivariate logistic regressions were employed to estimate associations between purging and outcomes. Four models were fit adjusting for binge eating and potential confounders of these associations.ResultsIn ALSPAC, 9.7% of girls reported purging in the 12-months prior to assessment, 7.3% in GUTS, and 3.5% in NFBC. In all 3 cohorts, purging was associated with adverse outcomes such as binge drinking (ALSPAC: odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4–2.9; GUTS: OR = 2.5, 95% CI = 1.5–4.0; NFBC: OR = 1.7, 95% CI = 1.0–2.8), drug use (ALSPAC: OR = 2.9, 95% CI = 1.8–4.7; GUTS: OR = 4.5, 95% CI = 2.8–7.3; NFBC: OR = 4.1, 95% CI = 2.6–6.6), depressive symptoms in ALSPAC (OR = 2.2, 95% CI = 1.5–3.1) and GUTS(OR = 3.7, 95% CI = 2.2–6.3), and several psychopathology measures including clinical anxiety/depression in NFBC (OR = 11.2, 95% CI = 3.9, 31.7).ConclusionsResults show a higher prevalence of purging behaviours among girls in the United Kingdom compared to those in the United States and Finland. Our findings support evidence highlighting that purging in adolescence is associated with negative outcomes, independent of its frequency and binge eating.
Highlights
Purging behaviours are described as the inappropriate use of laxatives, diuretics and slimming medications, as well as self-induced vomiting to control weight
The prevalence of purging was high across the three cohorts (9.8% Avon Longitudinal Study of Parents and Children (ALSPAC), 7.3% in Growing Up Today Study (GUTS), 3.5% in NFBC), higher in the United Kingdom than in the United States and the Finnish ones (ALSPAC > GUTS > NFBC)
A recent North American study found around 13% of their sample reporting purging behaviours in midadolescence (Neumark-Sztainer et al, 2011) suggesting that differences seen between the ALSPAC and GUTS cohort in this study could be due to socioeconomic homogeneity of the American sample and not to actual differences, and that secular trends could account for the higher prevalence of purging seen in this more recent study
Summary
Purging behaviours are described as the inappropriate use of laxatives, diuretics and slimming medications, as well as self-induced vomiting to control weight. Evidence suggests that some individuals engage in purging, but do not have AN nor do they engage in binge eating. The comorbidity of purging behaviours, such as vomiting, inappropriate use of laxatives, diuretics or slimming medications, has been examined in literature. Most studies do not include adolescents, individuals who purge in the absence of binge eating, or those purging at subclinical frequency. This study examines the prevalence of purging among 16-year-old girls across three countries and their association with substance use and psychological comorbidity. Our findings support evidence highlighting that purging in adolescence is associated with negative outcomes, independent of its frequency and binge eating.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
